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Changing Role of Hyaluronidase in Plastic Surgery

Bailey, Steven H. M.D.; Fagien, Steven M.D.; Rohrich, Rod J. M.D.

Plastic and Reconstructive Surgery: February 2014 - Volume 133 - Issue 2 - p 127e–132e
doi: 10.1097/PRS.0b013e3182a4c282
Cosmetic: Special Topics

Summary: Soft-tissue augmentation has become an increasingly popular option for facial rejuvenation. Hyaluronic acid fillers are part of the most rapidly expanding segment of this market, largely because of their safe drug profile and temporary nature. Despite their good safety profile, they can and do have complications ranging from superficial placement, uneven placement, granulomatous reactions, and skin necrosis. This article reviews the on- and off-label uses of hyaluronidase and presents several clinical algorithms detailing the effective and safe use of hyaluronidase to manage complications secondary to hyaluronic acid fillers.

Dallas, Texas

From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication March 24, 2013; accepted April 25, 2013.

Disclosure: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article.

Rod J. Rohrich, M.D., Department of Plastic Surgery, University of Texas Southwestern Medical Center, 1801 Inwood Road, Dallas, Texas 75390-9132,

©2014American Society of Plastic Surgeons